• Cardiac Tumor Resection and Reconstruction

    Definition

    Cardiac tumor resection is the removal of a tumor from the heart. The resection will also remove some of the healthy tissue surrounding the tumor.
    Reconstruction surgery may also be needed if a large area is affected.
    Anatomy of the Heart
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    Reasons for Procedure

    Tumors can interfere with the surrounding healthy tissue. This can lead to heart failure, blockage of blood flow, problems with the heart valves, or blood clots.
    Benign tumors can often be treated successfully with surgery.
    The surgery may be only part of the treatment of cancerous tumors. Treatment for these may also involve chemotherapy, radiation therapy, or both.

    Possible Complications

    Your doctor will review potential problems from the procedure, like:
    • Heart attack
    • Stroke
    • Damage to the heart, lungs, or other organs
    • Excess bleeding
    • Blood clots
    • Adverse reaction to anesthesia such as lightheadedness, low blood pressure, or wheezing
    • Nausea and vomiting
    • Infection
    • Soreness in throat
    Factors that may increase the risk of problems include:
    • Smoking
    • Chronic conditions such as kidney disease or diabetes
    Talk to your doctor about these risks before the procedure.

    What to Expect

    Prior to Procedure

    • Your doctor will ask about your family and medical history. You will also have a physical exam and blood tests.
    • An electrocardiogram will be done to examine your heart’s electrical activity.
    • Your doctor will also need images of the heart and tumor. These may be taken with:
      • Echocardiogram
      • Chest x-ray
      • Heart MRI
      • Chest CT scan
      Talk to your doctor about:
      • Any allergies you may have.
      • Any medications, herbs, or supplements you take.
      You may be asked to stop taking some medicines up to one week before the surgery, like:
      • Aspirin and other nonsteroidal anti-inflammatory drugs including ibuprofen or naproxen
      • Blood-thinning drugs such as warfarin (Coumadin)
      • Anti-platelet drugs such as clopidogrel (Plavix)
    • Aspirin and other nonsteroidal anti-inflammatory drugs including ibuprofen or naproxen
    • Blood-thinning drugs such as warfarin (Coumadin)
    • Anti-platelet drugs such as clopidogrel (Plavix)
    • Know what paperwork you will need to bring with you.
    • Do not eat or drink the night before your surgery.

    Anesthesia

    You will be given general anesthesia. It will block pain and keep you asleep during surgery.

    Description of the Procedure

    A breathing tube will be placed in your throat. Next, an incision will be made on the skin of the chest. A special device will help open the ribs to expose the heart. You will be connected to a heart-lung machine. This machine will take over for the heart and pump blood to your body during surgery. The heart can then be stopped so the surgery can begin.
    The tumor and some surrounding tissue will be removed. The doctor will remove as little tissue as possible without leaving tumor tissue behind. Repairs or reconstruction will be done to make sure the heart can still work properly. Once the repairs are complete, the heart lung machine will be removed and your heart will start beating again. Your heart will be observed to make sure it is working properly.
    Wires will be used to help close the ribs. The wire will support the breastbone as it heals. The skin will be closed with stitches or staples. A bandage will be applied over the incision.

    How Long Will it Take?

    About 3-5 hours.

    How Much Will it Hurt?

    Anesthesia prevents pain during surgery. You will have some pain during recovery. Your doctor will give you medication to help manage this pain.

    Average Hospital Stay

    You will be in the hospital for several days. The exact length of stay will depend on your surgery and recovery rate.

    Post-procedure Care

    At the Hospital
    You may be a little disoriented when you wake up because of the anesthesia.
    The first part of recovery will occur in an intensive care or coronary care unit. There will be several tubes and wires attached to you so your vital signs can be monitored.
    You will be given a liquid diet to start. You will be gradually worked back up to your regular diet.
    The hospital staff may ask you to:
    You may be a little disoriented when you wake up because of the anesthesia.
    The first part of recovery will occur in an intensive care or coronary care unit. There will be several tubes and wires attached to you so your vital signs can be monitored.
    You will be given a liquid diet to start. You will be gradually worked back up to your regular diet.
    The hospital staff may ask you to:
    • Move around in bed. It will help circulate the blood.
    • Increase your activity level each day.
    • Take deep breaths and cough. This will help keep your lungs clear.
    • Wear elastic stockings to promote blood circulation.
    At Home
    To help your recovery once you get home:
    To help your recovery once you get home:
    • Follow instructions to clean and care for the incision site
    • Track your temperature and weight as directed
    • Avoid lifting, pushing, or pulling anything weighing more than 10 pounds
    Ask your doctor:
    • When it is safe to shower, bathe, or soak in water
    • When you can start to drive again
    • When you can resume physical and sexual activity
    Be sure to follow your doctor’s instructions.

    Call Your Doctor

    Call your doctor if any of these occur:
    • Pain not controlled by the medicine given
    • Leg swelling
    • Fever
    • Severe depression
    • Shortness of breath
    • Signs of a heart attack:
      • Squeezing sensation or pressure in the chest
      • Radiating pain in one or both arms, neck, back, or jaw
      • Shortness of breath
      • Lightheadedness
      • Nausea
    • Squeezing sensation or pressure in the chest
    • Radiating pain in one or both arms, neck, back, or jaw
    • Shortness of breath
    • Lightheadedness
    • Nausea
    • Signs of a stroke:
      • Drooping or numbness in the face
      • Arm weakness
      • Difficulty speaking
    • Drooping or numbness in the face
    • Arm weakness
    • Difficulty speaking
    If you have an emergency, call for medical help right away.

    RESOURCES

    American Cancer Society http://www.cancer.org

    American Heart Association http://www.heart.org

    CANADIAN RESOURCES

    Canadian Cancer Society http://www.cancer.ca

    Heart & Stroke Foundation http://www.heartandstroke.com

    References

    Atrial myxoma. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated April 25, 2011. Accessed February 11, 2013.

    Caring for someone after heart surgery. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Caregiver/Resources/CaringforSomeoneAfterHeartSurgery/Caring-for-Someone-After-Heart-Surgery%5FUCM%5F301857%5FArticle.jsp. Updated December 28, 2011. Accessed February 11, 2013. Explore heart surgery.

    Paraskevaidis IA, Michalakeas CA, Papadopoulos CH, et al. Cardiac Tumors. ISRN Oncol. 2011;epub ahead of print May 26.

    Reardon MJ, Walkes JC, Benjamin R. Therapy insight: malignant primary cardiac tumors. Nat Clin Pract Cardiovasc Med. 2006;3(10):548-553.

    Warning signs of heart attack, stroke & cardiac arrest. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/911-Warnings-Signs-of-a-Heart-Attack%5FUCM%5F305346%5FSubHomePage.jsp. Accessed February 11, 2013

    What is Heart Surgery? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/hs. Updated March 23, 2012. Accessed February 11, 2013.

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